All the recent hoopla about the Affordable Care Act has generated a lot of heat but not much light. In all the angry finger-pointing, both parties have missed the main point. Obamacare is flawed and cumbersome for the same reason that our existing "system" doesn't work: It is a health insurance system, not a health care system. The obvious answer is a single-payer health care system, Medicare for all.

The administration is running into problems with technology and with cancellation of existing policies precisely because Obamacare is an insurance-based program. So we have to navigate insurance exchange websites, that must then connect up with insurance company databases, that must then correlate with existing insurance coverage, and so on. It's bound to be inefficient and confusing, and also costly.

Insurance companies take at least 20 cents out of every dollar Americans spend on health care; Medicare takes only 2 or 3 cents on the dollar. Health insurance companies are massively profitable, yet most Americans either can't afford health insurance or are very dissatisfied with the coverage they have, which is not only expensive but often not there for us when we need it most.

Those Americans fortunate enough to be on Medicare are very happy with it. Most of us, including President Barack Obama, knew that a single-payer Medicare for all system was by far the best way to reform American health care. But it didn't happen because it wasn't "politically doable." Most of our congressmen and state legislators are more responsive to the corporate interests who pay for their election campaigns than the people they claim to represent. This is true of both Republicans and Democrats. So single payer was never on the table because the health insurance lobby is simply too powerful.

If Obamacare ever gets off the ground, it will be helpful to many low-income Americans who will be able to afford health insurance. But it is a huge windfall for the health insurance industry, just as the Bush administration's prescription drug benefit was a huge windfall for the pharmaceutical industry.